Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $516.09 / $1,095.50 / $14,482.00	Facility		$516.09	$1,095.50	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $482.81 / $721.49 / $3,215.20	Professional		$482.81	$721.49	$3,215.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,740.00 / $4,780.00 / $7,344.00	Facility		$2,740.00	$4,780.00	$7,344.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $505.23 / $1,190.97 / $3,162.47	Professional		$505.23	$1,190.97	$3,162.47
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,507.48 / $1,507.48 / $1,507.48	Facility		$1,507.48	$1,507.48	$1,507.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,385.02 / $1,618.51 / $2,482.83	Facility		$1,385.02	$1,618.51	$2,482.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $775.96 / $2,230.54 / $2,649.01	Professional		$775.96	$2,230.54	$2,649.01
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $486.89 / $682.50 / $1,217.23	Facility		$486.89	$682.50	$1,217.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $516.09 / $1,049.07 / $5,261.00	Facility		$516.09	$1,049.07	$5,261.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $546.04 / $1,065.99 / $4,377.56	Professional		$546.04	$1,065.99	$4,377.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $61.84 / $316.93 / $1,015.79	Professional		$61.84	$316.93	$1,015.79
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $486.89 / $682.50 / $1,217.23	Facility		$486.89	$682.50	$1,217.23
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,056.25 / $1,287.00 / $1,921.24	Professional		$1,056.25	$1,287.00	$1,921.24
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,455.33 / $1,455.33 / $4,017.35	Facility		$1,455.33	$1,455.33	$4,017.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $989.37 / $2,516.05 / $4,377.56	Professional		$989.37	$2,516.05	$4,377.56
Security Health Facility/Professional Professional Modifier Low / Median / High Price $852.66 / $2,661.09 / $3,365.39	Professional		$852.66	$2,661.09	$3,365.39
United Facility/Professional Facility Modifier Low / Median / High Price $2,723.00 / $3,912.00 / $5,865.00	Facility		$2,723.00	$3,912.00	$5,865.00
United Facility/Professional Professional Modifier Low / Median / High Price $546.04 / $1,055.89 / $2,289.61	Professional		$546.04	$1,055.89	$2,289.61